The present application relates, in general, to antihypertensive drug therapy. In particular, the application relates to controlling hypertension episodes round the clock.
Hypertension is an inevitable disease of all populations in their second half-century of life, no matter who-or-where they may be. Moreover, hypertension assertedly creeps-up linearly with time, and soon enough becomes the major cause of morbidity and mortality. Severe hypertension insidiously damages the central nervous system—even in a victim barely into his or her second half-century. See e.g., New England Journal of Medicine.
Increased blood pressures are associated with increased chances of having a stroke, heart attack, kidney failure or heart failure and a whole host of other maladies or health complications. Medical classification of hypertension is based on blood pressure ranges. An exemplary blood pressure classification in common use is as follows:
Blood Pressure Classification Table11575Desireable120-13980-89Prehypertension140-15990-99Hypertension Stage 1160 or over100 or overHypertension Stage 2
As the blood pressures rise above 115/75 there is an increased incidence of the above-mentioned complications. This increased incidence worsens as the blood pressure increases above 115/75 (i.e., mean arterial pressures above 95 mm Hg) are linearly bad. Deterioration of the vascular beds of several heavily vascularized vital organs (e.g., kidneys, heart and brain) appears to be linear with the time-integral of mean arterial pressure above a desirable threshold of 95 mm Hg. On top of general vascular bed-rot, macro problems such as various flavors of myocardial ‘remodeling’, heart failure, etc. occur.
A problem with current diagnosis and treatment of hypertension is that they are usually based on only an individual or few measurements of blood pressure without taking into account of hypertensive episodes or excursions that may contribute to a higher time-integral of mean arterial pressure above the desirable threshold of 95 mm Hg. See e.g., Powers B, et al “Measuring blood pressure for decision making and quality reporting: where and how many measures?” Ann Intern Med 2011; 154: 781-788, and Appel L, et al “Improving the measurement of blood pressure: Is it time for regulated standards?” Aim Intern Med 2011; 154: 838-839. Both of these references and all other references cited in this disclosure are incorporated by reference herein in their entireties.
Consideration is now given to ways to promptly treat blood pressure increases in an individual toward reducing the time-integral of mean arterial pressure above a desirable threshold of 95 mm Hg.